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Anatomy & Pathophysiology

Dorsal Extensor Compartments:

Embryology of Upper limb

:

Dorsal Extensor Compartments:

Comp   

Tendons   

Notes

Pathology   

1   

EPB, APL   

Both in separate synovial sheaths

De Quervains   

2   

ECRL, ECRB   

radial to Lister's tubercle

Carpal boss   

3   

EPL   

ulnar to Lister's tubercle

Rupture over Lister's tubercle   

4   

EDC, EIP   

common synovial sheath

Tenosynovitis & ruptures   

5   

EDM   

Double tendon, over DRUJ

 Tenosynovitis & ruptures   

6   

ECU   

lies over distal ulna

Subluxing at ulnar styloid   

Extensor Hood & Tendons:

Extensor tendon Complex

The Lateral Bands [16] are held dorsally by the Triangular Ligament [17] and volarly by the Transverse Retinacular Ligaments [15].

The Transverse Retinacular Ligaments attach to the volar plate.

Imbalance of the lateral bands results in a swan neck or boutonniere deformity.

Oblique Retinacular Ligament (ORL) [13]:

  • Described by Weitbrecht (1969).
  • Extends from the flexor tendon sheath at the level of the proximal phalanx to the terminal tendon.
  • Coordinates the uniform flexion & extension of the PIPJ & DIPJs. 
  • When FDP flexes the DIPJ the ORL tightens & flexes the PIPJ thro a tenodesis effect.
  • As the extensors extend the PIPJ the ORL helps extend the DIPJ. (from 90 to 70deg. only) - Where there is loss of the terminal tendon (Mallet finger) the ORL may extend the DIPJ.

Sagittal Band [5]:

  • Connect extensor tendon to volar plate of MCPJ.
  • Aids extension of MCPJ
  • In hyperextension of the MCPJ the IPJs fall in to flexion because the extensor tendon distal to the sagittal band becomes lax. In this position the IPJ's can only be extended by the intrinsics.


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